Thyroid-stimulating activity in sera of normal pregnant women.

To evaluate the effect of a thyroid stimulator on thyroid function in the sera of normal pregnant women, we measured thyroid-stimulating activity (TSA) using a highly sensitive bioassay based on cAMP accumulation in cultured rat FRTL-5 thyroid cells. Serum was pretreated with 10% polyethylene glycol (PEG), and the supernatant (PEG-pretreated serum) was then used in the following studies. FRTL-5 cells were preincubated in 5H medium and incubated for 2 h with PEG pretreated serum, and cAMP was measured. All 11 patients with untreated hyperthyroid Graves' disease with strongly positive thyroid-stimulating antibody activity had normal TSA, because only 5.6% of their immunoglobulin G was recovered in the PEG-pretreated serum. In 32 normal pregnant women, 29 (91%) had positive TSA. Their TSA showed statistically significant positive correlations with serum hCG and free T4 levels, and a negative correlation with serum TSH levels. Moreover, when hCG was absorbed from sera by incubation with the solid phase anti-HCG monoclonal antibody, a significant positive correlation was observed between the rate of decrease in hCG and that in TSA. In conclusion, 1) TSA exists in the sera of normal pregnant women, which reflects hCG itself; and 2) thyroid glands of normal pregnant women may be stimulated by TSA to induce a slight suppression of TSH but not sufficient to induce overt hyperthyroidism.

Immunocytochemical presentation of alpha-fetoprotein-producing gastric cancer in ascitic fluid: a case study.

A case of primary gastric cancer without hepatic metastasis showing extremely high alpha-fetoprotein (AFP) levels is reported. This case illustrates the application of the immuno-peroxidase technique to ascitic fluid cytology. Papanicolaou-stained smears of the ascites permitted the diagnosis of a metastatic carcinoma. A positive reaction to AFP was demonstrated in the tumor cells in the ascitic fluid cellular samples as well as in the paraffin-embedded tissue section of the primary gastric carcinoma. Rising AFP levels were also detected in ascitic fluid. AFP fractionation using lectin-affinity-crossed-line immunoelectrophoresis showed the hepatic rather than yolk sac type. Reports of such occurrences are few; no study, to the best of our knowledge, has previously documented cytological and immunocytochemical diagnosis in ascitic fluid. AFP-producing gastric cancer should be considered in the differential diagnosis.

Application of immunoperoxidase staining in the cytodiagnosis of herpes simplex keratitis.

In corneal scraping smears from 13 patients with clinically suspected herpes simplex keratitis (HSK), HSK is demonstrated by means of peroxidase-antiperoxidase (PAP) technique with antisera to herpes simplex virus (HSV) in Papanicolaou-destained cellular samples. The staining for HSV antigen was present in seven cases of corneal scraping smears with superficial keratitis (dendritic and geographic ulcers) while six cases of stromal keratitis (deep keratitis) failed to show HSV antigen except in one case. Specific antigen for HSV was predominantly present in the cytoplasm rather than in the nucleus. Immunoreactions were negative with HSV antisera in patients with other infections and in those in a normal control group. Using the PAP technique, detection of HSV antigen in corneal scraping smears was of great value in the diagnosis of HSK, especially in cases of superficial keratitis.

Immunocytochemical demonstration of Chlamydia infection in the urogenital tracts.

The peroxidase-antiperoxidase (PAP) technique was applied in cellular samples for the detection of chlamydial infection. Urethral scrapings were obtained from 316 males with clinically suspected urethritis. Positive PAP staining was detected in 118 (37%) of 316 tested. Cellular samples from the endocervix of 25 (54%) of 46 female contacts of males with positive Chlamydia-infected cells had positive Chlamydia-PAP staining. Chlamydia was also found in 12 (25%) of 48 male with gonorrhea. Serum IgG antibodies against Chlamydia trachomatis were evaluated using an enzyme-linked immunosorbent assay. A total of 29 out of 73 patients had positive Chlamydia serology; of these, 21 were positive for PAP staining, and eight were negative. The determination of Chlamydia antigen by means of the PAP technique appears to be a satisfactory method for detecting Chlamydia in male and female genital specimens; also, the procedure can be done readily in most laboratory settings.

Cytodiagnosis of herpes simplex keratitis by means of an immunoperoxidase technique. A case report.

Typical herpes simplex keratitis that developed in a 5-year-old boy was initially diagnosed cytologically in Papanicolaou-stained samples. Subsequently, an immunoperoxidase staining technique was used to identify the specific type of herpes simplex virus (HSV) in the destained cellular samples. The positive staining helped to establish the diagnosis of a type 1 HSV infection, permitting early treatment with acyclovir and subsequent complete recovery from the ocular herpetic infection. Emphasis is placed on the value of the immunoperoxidase technique for the rapid and specific diagnosis of cases of suspected HSV infection.

Association of mast cells with vaginal trichomoniasis in endocervical smears.

In endocervical smears obtained from 40 women with Trichomonas vaginalis infection, 25 women with infections other than T. vaginalis and 35 cytologically normal women, inflammatory cells consistent with mast cells (tissue basophils) were examined. Mast cells were present predominantly in the smears of patients infected with T. vaginalis but were infrequent in those of patients with other infections and in those of the normal, control group. The numbers of mast cells in endocervical smears and the white blood cell counts in vaginal discharges showed a positive correlation with the degree of T. vaginalis infection. Our data seem to indicate that the presence of mast cells in the uterine cervix may be an immunologic response, possibly of an allergic nature, to T. vaginalis.

Mucoepidermoid carcinoma of the salivary gland in pleural fluid. A case report.

The cellular features of mucoepidermoid carcinoma of submandibular gland origin observed in pleural fluid are presented. The pleural fluid contained predominantly atypical spheroid cell clusters accompanied by numerous mesothelial cells. The cells had round nuclei with conspicuous nucleoli, coarsely granular chromatin and abundant cytoplasm with vacuoles. The cellular features of the malignant cells in the pleural fluid were correlated with the histology of the parent lesion.

Intracytoplasmic inclusions in urinary sediment cells from a patient with mucocutaneous lymph node syndrome (Kawasaki disease). A case report.

An intracytoplasmic inclusion seen in cells in the urinary sediments of a patient with the mucocutaneous lymph node syndrome (Kawasaki disease) is described. Cytochemical features suggested that the inclusion-bearing cells may be derived from mononucleated phagocytic cells. The presence of these cells may be related to the acute febrile phase of the disease.

Cytologic demonstration of Entamoeba histolytica using immunoperoxidase techniques. Report of two cases.

An indirect immunoperoxidase technique to detect Entamoeba histolytica in cell samples from patients suspected to have amebiasis is described. Using a rat antiserum specific for E. histolytica, the organism was clearly identified both in smears and in cell blocks. This immunoperoxidase technique seems to offer great possibilities for a specific, accurate and rapid identification of amebic infestation in diagnostic cytology.

Meningitis with Acinetobacter calcoaceticus in cerebrospinal fluid. A case report.

A case of meningitis due to Acinetobacter calcoaceticus occurred after neurosurgery. The cerebrospinal fluid cytology showed intracellular diplococci that strongly resembled Neisseria meningitidis. However, subsequent bacteriologic studies revealed a bacterium identical to A. calcoaceticus. It is of practical importance for cytology laboratories to recognize this diplococcal form of organism.

[Laboratory and clinical studies on latamoxef in the field of obstetrics and gynecology].

Latamoxef (LMOX) is a new antibiotic synthesized by Shionogi Research Laboratory. Chemically LMOX is especially unique with a sulfur atom replacing the oxygen atom in the 1 position of the conventional cephalosporin nucleus, and in addition, this antibiotic has a cephamycin-like structure. The antibacterial activity of LMOX shows high potency against Gram-negative bacteria, but tends to be weak against Gram-positive bacteria. The tissue levels of LMOX in humans after intravenous injection of 1 g were examined. The levels in uterine and adnexa uteri tissue at 1 hour after administration were 25.4 and 27.4 micrograms/g respectively. LMOX was administered to 147 cases in infections of obstetric and gynecological field. The clinical effect according to disease was 94.6% for intrauterine infections, 95.0% for adnexitis, 87.0% intrapelvic infections, and 100% for external genital organ infections, making a total of 92.5%. The rate of occurrence of side effects or abnormal laboratory findings was similar to or slightly less than that seen with other beta-lactam antibiotics.

[Clinical evaluation of granisetron hydrochloride against nausea and vomiting induced by anticancer drugs for gynecological malignant tumors].

We, in the Department of Obstetrics and Gynecology, Kansai Medical College, conducted an evaluation of the usefulness and safety of granisetron hydrochloride used for nausea and vomiting due to chemotherapy in patients with gynecological malignant tumors, with an additional study of the efficacy of different regimens. The subjects were 9 patients in whom 16 courses of CAP therapy were given (group A) and 13 patients in whom 24 courses of CAP therapy were given (group B). Granisetron hydrochloride 3 mg/body was administered by intravenous drip in the two groups before chemotherapy. Clinical symptoms of nausea, vomiting, and anorexia were observed for 2 days after anticancer drugs were administered in order to evaluate its efficacy. The percentage of patients who responded as "effective" or better was 90.0%. In different regimens, the efficacy was 93.8% in group A and 87.5% in group B. These results indicated clinically high usefulness in both groups. No side effects related to granisetron hydrochloride were found in this study.

[Phase II study of UFT in cancer of the uterine cervix].

UFT Phase II study was undertaken as a joint research project at 6 institutions on 36 patients with cancer of the uterine cervix. Results showed that, in the 25 of 36 cases in whom results and conclusions were feasible, there was an effectiveness of 16% (CR 3 cases, PR 1 case, NC 17 cases, PD 4 cases). Histologically, there was 25% effectiveness with large-cell, non-keratinizing, epidermoid carcinoma, against 16.7% with small-cell type. Considerable effect was noted as to metastasis effect in terms of location: Virchow 50%, and lungs 33.3%. CR effectiveness was noted in one case of local recurrence following irradiation. In 10 (37%) of the 27 evaluable cases some side effects were observed. Virtually all involved the digestive organs, and serious bone-marrow problems, hepatic or renal impairment were not evident. The findings suggested that UFT is an effective chemotherapeutic agent against carcinoma of the uterine cervix.

[Epidemiology of malignant tumors of the female genital organs].

Incidence, risk factors, prognosis and 5-year survival of the malignant tumors in the female genital organs, except the trophoblastic diseases, were described. The uterine cervical cancer is the most in Japan, but is already one the controlling cancer, though prognosis of the cervical adenocarcinoma is still poor. Incidence of the endometrial cancer is increasing. Ovarian malignant tumor is one of silent diseases and their 5-year survival rate is very low. Significant of the annual population screening against them was emphasized.

Influence of a cigarette smoke extract on the hormonal regulation of platelet-activating factor acetylhydrolase in rats.

We evaluated the effects of estrogen, progestin, and cigarette smoke extract (CSE) on plasma platelet-activating factor (PAF) acetylhydrolase (AH; PAF-AH) activity in rats. The effects on rat tissues of an i.v. injection of PAF were studied as part of our investigation of the mechanisms involved in thrombotic episodes. Plasma PAF-AH activity in adult female rats (14 wk of age) treated with 17 alpha-ethynylestradiol (100 micrograms/kg, 5 days) was decreased by 70%. Medroxyprogesterone (50 mg/kg, 5 days) increased PAF-AH activity by 50%. CSE (0.5 cigarette/kg, 5 days) did not alter PAF-AH activity during the treatment. However, a combination of CSE and 17 alpha-ethynylestradiol decreased plasma PAF-AH activity by 90%. The decrease in PAF-AH activity was age-dependent. The effect of medroxyprogesterone on plasma PAF-AH activity was not influenced by CSE. When PAF (5-40 nmol/kg) was injected i.v. into untreated adult female rats, 9 of 16 animals died after a 20-nmol/kg dose of PAF. Macroscopic findings included hemorrhage, hyperemia, and congestion in the lungs and heart, and necrosis-like changes in the gastrointestinal tract. Microscopically, thrombi were observed in the lungs and heart. When PAF was administered to adult female rats pretreated with sex steroid hormones, the mortality of rats with low plasma PAF-AH activity caused by 17 alpha-ethynylestradiol was increased but that of rats with high PAF-AH activity caused by medroxyprogesterone was decreased. Thus, PAF and PAF-AH may play important roles in the thrombotic episodes known to occur in female smokers who use oral contraceptives.

[Positive and negative effects of progestins on platelet-activating factor acetylhydrolase activity in rat plasma].

Platelet-activating factor acetylhydrolase (PAF-AH), the enzyme that inactivates PAF, is regulated by steroid hormones including progestin. It has been reported that 17 alpha-ethynylestradiol decreases plasma PAF-AH activity and medroxyprogesterone increases the enzyme activity. In this study, we elucidated the effects of various progestins on plasma PAF-AH activity and lipoprotein cholesterol levels. Plasma PAF-AH activity in female adult rats treated with either progesterone or 17 alpha-hydroxyprogesterone (50mg/kg, 3 days) did not change significantly. Both medroxyprogesterone and megestrol acetate (50mg/kg, 3 days) significantly increased plasma PAF-AH activity, but both norethindrone acetate and norethynodrel (50mg/kg, 3 days) significantly decreased the enzyme activity. In addition, not only did medroxyprogesterone increase plasma PAF-AH activity but plasma lipoprotein cholesterol and norethindrone acetate decreased both of them. A significant correlation between plasma PAF-AH activity and the lipoprotein level was found (r = 0.974, p < 0.01). When PAF (10nmol/kg) was administered to female adult rats pretreated with progestins, the mortality of the rats that had low plasma PAF-AH activity due to norethindrone acetate was increased in the same manner as observed in the 17 alpha-ethynylestradiol-pretreated group. These findings indicate that progestins have various effects on plasma PAF-AH activity and the lipoprotein level. In addition, some progestins, which have an estrogenic effect on enzyme activity, may be related to the thrombotic episodes observed in oral contraceptive users.